Coping with a life-changing disease

Contemplating the future at the Fairmont Orchid on the Big Island

Contemplating the future at the Fairmont Orchid on the Big Island

TL;DR: I expect that I’ll be fine. I debated whether to post this, but decided that there was an off-chance that someone might find this information valuable. 

I was diagnosed with diabetes in September.

For someone who has never been admitted to a hospital or regularly taken any sort of medication, the last few months have been quite an adjustment. I’ve been to doctors’ offices more since September than I have the rest of my life. I’ve had to deal with fatigue that on some days made it hard to get out of bed.

My “vacation” to Hawaii earlier this year was spent figuring out how to check my blood sugar daily (the user interface design on medical devices is terrible!) and figuring out the major lifestyle changes I would have to make.

The Hawaiian islands illustrate the circle of life. On the Big Island, lava spews forth creating new land. But with Kauai, you’ve got a dying island with ancient cliffs falling into the ocean. Visitors to the islands also illustrate this. Many come for their honeymoons, where undoubtedly new life is conceived. But many also come to have a last wish fulfilled. (I was reminded of this by a sign at Kona airport advising passengers to remove breathing machines from baggage for separate screening.)

The adjustment has been even harder because I recently moved and don’t know many people in the Bay Area.

I feel old and angry. Old because it’s not a disease that people my age typically get. Angry because I didn’t adjust my habits earlier.

In the grand scheme of things, there are much worse things to have than diabetes. Mine was caught early and with some significant changes, I can lead a mostly normal life.

The biggest changes so far have been in diet and exercise. I’ve forced myself to get used to eating smaller portions and on a more regular basis.

Eating right is a surprisingly difficult thing. Most of the incentives around us are to eat poorly. It’s especially hard when you travel as much as I do. Fortunately, my health insurance covered a diet coach. Even as a well-educated adult, I was surprised at what I didn’t know about nutrition.

Adjusting food and drink is especially hard because there is often a social component to eating. Still, I’ve managed to all but eliminate dessert from my vocabulary. (I made exceptions to split a piece of cake with a friend for her birthday and again for my brother’s birthday.)

I’ve tried to take a scientific approach to the disease. After a night of drinking with friends, I tested my blood sugar and found it off-the-charts high. (Can’t do that again.) In other cases, I’ve been pleasantly surprised that foods that I like and thought I’d have to give up didn’t spike my blood sugar.

As a technologist, I’m impressed by how many companies, especially startups, are focused on helping people live better. It’s a marked contrast with companies like Monsanto and Cargill that profit from obesity.

I’ve been using a Fitbit regularly to make sure I exercise. I’ve set a goal of 10,000 steps a day, with self-imposed penalties if I don’t make it. Sometimes this results in doing silly things like laps of downtown Palo Alto. (It’s 2,373 steps for me to do a walking loop of University Avenue from High to Webster.)

I also have a Withings scale, which tracks weight and body fat.

Both devices take data and make it easily accessible. They cost a lot more than their non-Internet connected counterparts, but I find having the data automatically stored to be well worth it. I’ve even pulled up my Fitbit records at the doctor’s office.

Glooko offers a hardware/software solution for diabetics to keep track of their glucose levels. Withings also offers a blood pressure monitor.

They’re different from traditional medical devices in that they focus on great user experience, are designed with the Internet in mind and relatively affordable. (Though, sadly, not covered by insurance or eligible for various government medical tax breaks.)

Devices like these are the embodiment of improving what you measure. The vast majority of days, I hit my goals.

With changes in diet and exercise, I’ve lost about 10 pounds in the last two months. That feels good.

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About Rakesh Agrawal

Rakesh Agrawal is Senior Director of product at Amazon (Audible). Previously, he launched local and mobile products for Microsoft and AOL. He tweets at @rakeshlobster.
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5 Responses to Coping with a life-changing disease

  1. Nicely done. Keep it up man!

  2. Johny Miric says:

    Bad eating habits are so common in today’s world and practicly most of the people are unable to regulate it. Bad eating habits have it’s roots in emotions, usually disatisfaction with your life situation or because of some particular problem. I could introduce you with few simple tools which could help you fight this thing off, for last 10 years I’m working in natural and alternative medicine, I have contacts all over the world in this field and if you want I can give you few tips. Once I’m in office today I will send you something, a special audio recording to help you deal with poor eating habits.

  3. robinahn says:

    I’m sorry to hear about your diagnosis. I’ve grown up with diabetes as a spectre around my house: grandma had it and mother is on the cusp right now. Mom has to lose about 10kg and keep it off for it to be a non-issue, which should take about a year of consistent effort. Does the Withings scale live up to it’s promise?

  4. Hi Rocky,

    I hate to say this, and I know your doctors and nutritionist are going by what they have learned from textbooks, field work, and clinical trials (mostly from the ’90s), which encourage diabetics to eat every 4-5 hours. However, I think some researchers are actually starting to disagree with the “grazing is better for insulin resistance/glucose control.” For example, see this clinical trial currently underway (look especially at the “hypothesis” section).

    http://clinicaltrials.gov/ct2/show/NCT01277471

    See this post on my favorite nutrition/exercise blog, commenting on a 2010 study that found 3 meals superior to 6 for insulin/glucose control. This was for healthy subjects though the study authors noted “This could potentially have profound implications for individuals with glucose intolerance or those with type 2 diabetes, and should be studied further in this population.” The ongoing clinical trial I cited above is doing exactly that, comparing 2 meals/day with 6. It will be interesting to see the results when published.

    Also, I’m sure they already have you on it, but many studies recommend chromium supplementation.

    http://www.ajcn.org/content/78/1/192.1.full

    Congrats on the weight loss, keep up the hard work!

    BTW there is a startup called fitocracy.com that has some cool exercise-tracking features on top of a social platform. I will email you an invite as they are in “expanded beta” mode.

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